Optimizing the cataract order of the list in modern surgery

Ruan, Claire W; Win, Sai; Francis, Katherine E.; Francis, Ian C.

doi:10.1016/j.jcrs.2014.03.003

Cited by 2 publications

(5 citation statements)

References 2 publications

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Order By: Relevance

“…There was a tendency to place the intermediate cases (case C and case E) either third or fourth on the list, whereas no preference was found for the second place on the list (p=0.12). The last position on the list was more commonly reserved for the riskiest case (case D) (48; 32.43%), followed by the least risky case (case B) (41; 27.7%) (see table 4 and online supplemental data 1 and 2). There was no significant correlation between the default order the case notes were presented (case A, case B, case C, case D, case E) and the orders ranked by the 148 participants who answered this question (p=0.0833).…”

Section: Resultsmentioning

confidence: 99%

“…Several studies have suggested that starting with the easier or less risky cases allows the surgeon to ‘warm-up’ and thus be more confident in managing more complex and risky cases. 4 5 Although this trend was perceptible for the majority, there was no significant difference between the numbers of surgeons who preferred to start with the least risky compared with the most at risk case.…”

Section: Discussionmentioning

confidence: 97%

“…When asked to order the five hypothetical patients with cataract, majority of the respondents placed the least risky cases first (case A and case B), followed by cases of intermediate risk (case C and case E), leaving the riskiest (case D) for last. Several studies have suggested that starting with the easier or less risky cases allows the surgeon to ‘warm-up’ and thus be more confident in managing more complex and risky cases 4 5. Although this trend was perceptible for the majority, there was no significant difference between the numbers of surgeons who preferred to start with the least risky compared with the most at risk case.…”

Section: Discussionmentioning

confidence: 99%

“…2 The resulting COR was proposed as an indicator of the cumulative risk of PCR and indirectly the complexity of the particular case. 2 Ruan et al 4 demonstrated that the patient's characteristics (and thus case complexity) influence the psychological comfort of both the ophthalmic surgeon and the surgical team, which in turn impacts surgical performance. The authors concluded that the optimisation of the order of a cataract list would be beneficial for surgical performance and suggested placing the more complex cases at the end of the list, on the basis that the level of a surgeon's dexterity and comfort would be optimal.…”

Section: Introductionmentioning

confidence: 99%

“…The authors concluded that the optimisation of the order of a cataract list would be beneficial for surgical performance and suggested placing the more complex cases at the end of the list, on the basis that the level of a surgeon’s dexterity and comfort would be optimal. 4 In this regard, CORs could be used as an objective measure to order the cataract list according to case complexity.…”

Section: Introductionmentioning

confidence: 99%

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Establishing the influence of case complexity on the order of cataract lists: a cross-sectional survey

et al. 2021

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ObjectiveOrder of the theatre list and complexity of the cases are important considerations which are known to influence surgical outcomes. This survey aimed to establish their influence on cataract surgery.Methods and AnalysisCataract surgeons ordered five cataract cases according to their surgical preference, first using case notes and second using composite ORs (CORs) for posterior capsule rupture. Descriptive and non-parametric statistics were used to analyse the data.ResultsBetween 11 June and 14 July 2020, 192 cataract surgeons from 14 countries completed the online survey. Majority of the surgeons (142 vs 50) preferred to choose the order of their list (p<0.01) and to review the case notes prior to the day of surgery (89 vs 53; p=0.04). 39.86% preferred to start with the less risky case and 32.43% reserved the last position on the list for the riskiest case. There was a significant trend to order the list in an ascending level of risk, independent of whether case notes or CORs were used. Additionally, 44.79% of the respondents indicated they would be happy to have their list order planned by an automated program based on their preferred risk score.ConclusionThis survey demonstrates that cataract surgeons prefer to choose the order of their theatre list and that the order is dependent on the complexity of cases. There is support among surgeons for automated list ordering based on an objective score for risk stratification, such as a COR.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%